Along with signing up for Medicare Part A (inpatient coverage) and Part B (outpatient coverage), it is essential that one sign up for a supplemental plan (a Medigap plan). Supplement plans cover the gaps in medical care that are not covered by Medicare. There are multiple supplemental plans, each one has different coverage and benefits. Comparing the various supplemental plans (Medigap plans) that are available is the best way to determine which plan is the best fit for you. The best way to sort through the Medigap plans is to consult with an expert who knows all the ins and outs, pros and cons of each plan and can best match plan benefits and costs with your particular situation.
However, for a quick overview and some basic understanding of the differences between the various plans, check out each plan listed on this website by name. The poem by Judith Viorst “If I Were in Charge of the World” would be appropriate to quote here. “If I were in charge of the world”, I would have named the supplemental plans from best to worst. But no, there is no logical order to the supplemental plans. Case in point, Plan A, contrary to logic, is not the best and is not very popular.
Questions You Should be Asking
- What should you look for when assessing the cost-to-benefits of a Medigap plan? The following are some of the items that vary between Medigap plans and are typically was is compared when differentiating coverage and cost:
- Does the plan pick up your co-pay (coinsurance)? This is the amount remaining on medical bills after Medicare has paid their agreed-upon amount.
- Does your Medigap plan cover your Medicare Part A and/or Part B deductible?
- How many additional days in the hospital will your Medigap plan cover after Medicare benefits are used up?
- What specific items are covered and not covered? These include things like blood for transfusions, skilled nursing facility care coinsurance, You may also want to check if your Medigap plan covers foreign travel.
- Will your plan cover outpatient providers charges that are in excess of what Medicare will cover? Some doctors, counselors, and specialists do not agree to the Medicare-designated fee. You are responsible for paying the excess. Does your plan cover this?
- What is the cost of the plan’s premium? Sometimes coverage may be fairly identical yet the premium may be higher or lower for the same coverage
As stated above, Medicare Supplement Plan A, although the first listed, is not the best and is not very popular. Why? Because it has fewer benefits than other Medigap supplemental plans.
The following chart lists items that various Medigap plans cover, with the items checked that Plan A covers.
You may be curious what Medicare Plan A covers?
Plan A covers the big one – the 20% coinsurance (co-pay) of Medicare Part A (hospital costs) not covered by Medicare. It also covers the 20% coinsurance (co-pay) of Medicare Part B (outpatient services) that Medicare doesn’t cover.
An additional 365 days of inpatient care, hospital costs, and coinsurance are provided after your Medicare benefits have been used up. Please note that all Medigap plans include this benefit, so it’s not one you have to worry about checking out for each plan.
That’s All She Wrote
That’s where Medigap Plan A runs out of benefits. As you can see from the chart above, this Medigap plan does not cover coinsurance you may be charged for services at skilled nursing facilities. This Medigap Plan also will not cover your deductible, either for Medicare Part A (inpatient) or Medicare Part B (outpatient). Medigap Plan A also provides no coverage for “excess charges” — the part of the fee a doctor charges that are above and beyond the Medicare designated fee. With this Medigap plan, you would be responsible for all extra charges.
If you like to travel overseas, it is important to note that Medigap Plan A does not cover any costs that may be incurred due to a medical emergency overseas. If you become ill or have an accidental injury overseas and need medical care, you will be responsible for paying out of pocket.